This program is a LIVE virtual class covering Medicare coverage, coding, billing, and payment for critical access hospitals (CAHs) and rural health clinics (RHCs). This class is 8 sessions held Tuesdays through Fridays from 8:30 a.m. to 1 p.m. You may register for the CAH portion (6 sessions) or the RHC portion (2 sessions) if you do not wish to attend the full 8 sessions for both CAH and RHC.
This class designed specifically for CAHs and RHCs shows you which rules apply to you so you can successfully process claims and get paid without disruption to your revenue stream. It will also teach you how to research Medicare regulations to resolve billing issues and respond to denials. You’ll have the research tools and skills at your fingertips to answer your own Medicare questions long after the virtual event is over.
At the conclusion of this educational activity, participants will be able to:
- Find the answers to your specific Medicare questions relating to CAHs and RHCs
- Understand outpatient observation, inpatient status rules, and UR requirements at CAHs
- Submit accurate claims to Medicare, including CAH Part B inpatient billing
- Ensure appropriate reimbursement from Medicare for outpatient, inpatient, and swing bed services, including the application of the patient’s financial responsibility
- Research and resolve claim edits that cause denials and delay revenue in your CAH or RHC
- Understand RHC reporting of revenue codes, HCPCS codes, and related charges for all services provided
- Explain the AIR payment in independent and provider-based RHCs, including the application of Medicare Part B deductible and coinsurance
- Implement best practices to receive the revenue you deserve for your CAH and RHC while staying in compliance with the regulations
Judith Kares, JD, is an expert in Medicare rules and regulations and is an instructor for HCPro's Medicare Boot Camp. She spent a number of years in private law practice, representing hospitals and other health care clients, and then as in-house legal counsel prior to beginning her current legal/consulting practice. She is also an adjunct faculty member at the University of Phoenix, where she teaches courses in business and health care law and ethics.